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Diffuse-nodular adenomyosis

Diffuse-nodular adenomyosis is a combination of two forms of adenomyosis: diffuse and nodular. In this type of disease, endometrial cells penetrate the myometrium (the muscular layer of the uterus), forming both diffuse and clearly localized foci or nodes. This combination of two forms of the disease can lead to significant dysfunction of the uterus and cause serious symptoms that require timely treatment.

Symptoms of diffuse-nodular adenomyosis:

Lower abdominal pain that worsens during menstruation.
Menorrhagia (excessive bleeding) or prolonged menstruation.
Pain during intercourse (dysmenorrhea).
Irregular menstruation or intermenstrual bleeding.
Infertility or difficulty conceiving.
Enlargement of the uterus, which may be noticeable during a gynecological examination.
General weakness and discomfort in the abdomen.

Causes of diffuse nodular adenomyosis:

As with other forms of adenomyosis, the exact causes are not fully understood, but possible risk factors include:
Hormonal disorders, particularly elevated estrogen levels.
Uterine surgeries, such as cesarean sections, abortions, or other gynecological interventions.
Presence of endometriosis or other gynecological diseases.
Heredity, if there have been cases of adenomyosis in the family.
Frequent pregnancies and childbirth, which can contribute to the development of the disease.

Diagnosis of diffuse nodular adenomyosis:

Gynecological examination: Palpation of the abdomen to determine uterine enlargement or painful areas.
Ultrasound examination (US): Detects changes in the structure of the uterus, the presence of nodules and thickening of the walls.
Magnetic resonance imaging (MRI): This is the most accurate method for determining the prevalence of the disease, the presence of diffuse and nodular changes in the myometrium.
Hysteroscopy: Helps evaluate the inner surface of the uterus and detect possible polyps or other changes.
Laboratory tests: Blood tests to detect anemia and hormonal disorders, as well as tests for infections that may have similar symptoms.

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Treatment of diffuse nodular adenomyosis:

Medical treatment:

Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain.
Hormonal drugs such as contraceptives, progestins, hormonal spirals (Mirena) to reduce estrogen levels and reduce symptoms.
Gonadotropin-releasing hormone (GnRH) agonists to block estrogen and reduce the size of the nodes.

Surgical treatment:

Laparoscopy to remove or reduce endometriotic foci.
Hysterectomy (removal of the uterus) may be necessary in severe cases if other methods do not work.

Prevention:

Early detection of diffuse nodular adenomyosis allows for timely treatment and prevents the development of complications such as infertility.
Regular examinations by a gynecologist to monitor the condition of the uterus and the patient's health.

How is the consultation for suspected diffuse nodular adenomyosis:

Initial examination: The doctor interviews the patient about symptoms such as pain during menstruation, duration and nature of bleeding, pain during intercourse, and infertility.
Medical history assessment: Chronic diseases, previous uterine surgeries, abortions, or other risk factors are determined.
Gynecological examination: The doctor palpates the uterus to detect painful areas or changes in its size.
Diagnostic procedures: The patient may be prescribed an ultrasound, MRI, or hysteroscopy to confirm the diagnosis.
Discussion of the treatment plan: After the results of the examination, the doctor develops an individual treatment plan, which may include medication or surgery, depending on the patient's condition.

Diffuse nodular adenomyosis requires a careful approach to diagnosis and treatment to reduce the risk of complications and alleviate symptoms, allowing patients to lead a normal life.